Debate: Adult male circumcision

From Debatepedia

Is elective, adult male circumcision a good idea?

Background and context

Adult male circumcision is the removal of some or all of the foreskin (prepuce) from the penis. The word "circumcision" comes from Latin circum (meaning "around") and cædere (meaning "to cut").

Early depictions of circumcision are found in cave drawings and Ancient Egyptian tombs, though some pictures may be open to interpretation. Male circumcision is considered a commandment from God in Judaism. In Islam, though not discussed in the Qur'an, circumcision is widely practiced and most often considered to be a sunnah. It is also customary in some Christian churches in Africa, including some Oriental Orthodox Churches. According to the World Health Organization (WHO), global estimates suggest that 30% of males are circumcised, of whom 68% are Muslim. The prevalence of circumcision varies mostly with religious affiliation, and sometimes culture.

Debate surrounds adult male circumcision. Advocates for circumcision state that it provides important health advantages which outweigh the risks, has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physicians. Opponents of circumcision generally argue that it is extremely painful, adversely affects sexual pleasure and performance, may increase the risk of certain infections, and is against what nature or even God intended. Yet, this debate is not a legal one. It is merely a matter of personal choice. Nevertheless, it is a question that millions of men grapple with around the world - "Should I get circumcised?". The pros and cons are presented below.

No

Uncircumcised Europeans do not experience significant health problems. The vast majority of continental European men who are not Moslems are intact. If being intact leads to worse health outcomes, comparing data from Europe and America would reveal that. I know of no such comparison, except one: the circumcised USA has the highest frequency of HIV positive individuals in the OECD.

Most male sexual health problems stem from irresponsible sex, not circumcision. It is absolutely essential to always use a condom during casual sexual encounters and extramarital affairs. Having no foreskin is "healthy" in the trivial sense that nothing can go wrong with an absent organ. Parents should not assume that their sons will be sexually irresponsible in a way that will defy their authority, but instead should teach their sons to respect the opposite sex and themselves. And failing that, to use a condom!

Circumcision is not a good solution to phimosis of foreskin Phimosis is a situation in which the foreskin has difficulty retracting or returning over the head of the penis due to abnormally tight foreskin. This, however, can be solved by other means than circumcision. In addition, doctors often mistaken the natural state of the infants foreskin (which does not retract until later years) as phimosis, and subsequently mistakenly opt to circumcise the infant.

Ideologies drive false medical justifications for circumcision Circumcision has been driven by a religious and other ideologies that have, for example, considered masturbation a sin and circumcision a solution to this sin. Medical studies and conclusions are often driven by a desire to justify these ideological positions.

"Is Non-Therapeutic Circumcision Ethical?". National Organization of Circumcision Information. Opposing Views - "Routine circumcision gained popularity in English-speaking countries during the Victorian era, supposedly to reduce the incidence of masturbation, which was mistakenly believed to cause disease. While the strategy failed, recognition of the sexual importance of the foreskin was made clear. Unfortunately, what did work, from that disingenuous introduction into Western medicine onward, was that circumcision became the miracle treatment for the dreaded disease of the day. None of the supposed benefits of circumcision has withstood scientific scrutiny, but that didn’t stop the process whereby, when one justification was disproved, another was adopted to take its place."

1. HIV/AIDs. In the past 20 years since the outbreak of the HIV/AIDS epidemic more than 20 million people have died, and 40 million people now carry HIV with 2.5 million new cases each year. More than 30 separate studies, including the gold standard, 3 randomized clinical trials in the past 3 years, have proven that circumcision is 50-60% effective in preventing the acquisition of HIV on exposure. This evidence is accepted by the UN, the World Health Organization (WHO) and the U.S. NIH among others, and 5 African countries are starting mass adult circumcision programs. At the same time multiple attempts at developing an HIV vaccine have failed."

No

Circumcision is actually a rare practice in the world.Paul M. Fleiss, MD. "The Case Against Circumcision". Mothering. Winter 1997 - "How Common Is Circumcision? Circumcision is almost unheard of in Europe, South America, and non-Muslim Asia. In fact, only 10 to 15 percent of men throughout the world are circumcised, the vast majority of whom are Muslim.29 The neonatal circumcision rate in the western US has now fallen to 34.2 percent.30 This relatively diminished rate may surprise American men born during the era when nearly 90 percent of baby boys were circumcised automatically, with or without their parents' consent."

Condoms/education are better than circumcision against HIV."Circumcision Falsehoods: Don't Be Conned by the Pros". National Organization of Circumcision Information. Opposing Views - "AIDS has been curbed successfully in Thailand, Senegal, and Eastern Uganda by governments taking a strong leadership role, targeting commercial sex workers and the populace with an aggressive educational campaign, and distributing free condoms. Condoms are 95 times more cost-effective than circumcision. Promoting expensive circumcisions in a continent lacking adequate food, safe water, good hygiene, and modern medical facilities, is a deadly approach, likely to exacerbate the pandemic."

No

Circumcision always risks permanent injury and disfigurementPaul M. Fleiss, MD. "The Case Against Circumcision". Mothering. Winter 1997 - "Circumcision disfigures: Circumcision alters the appearance of the penis drastically. It permanently externalizes the glans, normally an internal organ. Circumcision leaves a large circumferential surgical scar on the penile shaft. Because circumcision usually necessitates tearing the foreskin from the glans, pieces of the glans may be torn off, too, leaving it pitted and scarred. Shreds of foreskin may adhere to the raw glans, forming tags and bridges of dangling, displaced skin[...]Depending on the amount of skin cut off and how the scar forms, the circumcised penis may be permanently twisted, or curve or bow during erection. The contraction of the scar tissue may pull the shaft into the abdomen, in effect shortening the penis or burying it completely."

Sexuality: Does circumcision aid or harm sexual performance?

Yes

Circumcision increases sexual stamina and satisfaction. A number of studies have found that circumcised males have greater stamina (or lower rates of premature ejaculation) than uncircumcised men. The longer a man can last, the more likely he is to cause a women to orgasm or orgasm multiple times. This is more gratifying for men.

Circumcised men engage in more varied sexual activity. Laumann et al. reported that circumcised men in their survey displayed greater rates of experience of various sexual practices, including oral sex, anal sex, and masturbation.[29] For example, among whites the "estimated ratio of the odds of masturbating at least once a month for circumcised men was 1.76 that for uncircumcised men." Dr. Laumann provides two explanations for the difference in sexual practices. "One is that uncircumcised men, a minority in this country, may feel a stigma that inhibits them. Another is that circumcision reduces sensitivity in the penis, leading circumcised men to try a range of sexual activities."[1]

Those circumcised in adulthood note improved sex The reactions of uncircumcised men that became circumcised later in life is that it improved their sexual performance and pleasure. This is important group to follow because they are the only group that experienced sex with an uncircumcised and circumcised penis.

Sex with an uncircumcised penis can be painful for men.Dr David Hawker. "The Benefits of Male Circumcision". CircInfo.com. March 2004 - "there are many other situations where circumcision helps prevent future disease or discomfort.[...]If the foreskin cannot easily be moved when the penis becomes hard, or if that causes pain - this is not only a childhood problem. At puberty, as the penis grows and masturbation begins, problems may emerge. Some men have pain on intercourse, which they then try to avoid for that reason. If so, you (and your partner) will benefit from your circumcision just as many boys do. Some men are afraid to admit to this problem, but it is curable by circumcision."

Circumcised and uncircumcised men have statistical equal stamina Waldinger et al. recruited 500 men (98 circumcised and 261 not-circumcised) from five countries: the Netherlands, United Kingdom, Spain, Turkey, and the United States and studied their ejaculation times during sexual intercourse. They found that circumcised men took on average 6.7 minutes to ejaculate, compared with 6.0 minutes for uncircumcised men. This difference was not statistically significant. The comparison excluded Turkey, which was significantly different from the other countries studied.[30] Commenting on the study, Sorrells et al. said "Turkish men, the vast majority of whom are circumcised, had the shortest Intravaginal ejaculation latency time (IELT)."[2]

Circumcision shortens the penis.Paul M. Fleiss, MD. "The Case Against Circumcision". Mothering. Winter 1997 - "Circumcision denudes: Depending on the amount of skin cut off, circumcision robs a male of as much as 80 percent or more of his penile skin. Depending on the foreskin's length, cutting it off makes the penis as much as 25 percent or more shorter. Careful anatomical investigations have shown that circumcision cuts off more than 3 feet of veins, arteries, and capillaries, 240 feet of nerves, and more than 20,000 nerve endings.31 The foreskin's muscles, glands, mucous membrane, and epithelial tissue are destroyed, as well."

Circumcision can cause male impotencyPaul M. Fleiss, MD. "The Case Against Circumcision". Mothering. Winter 1997 - "Circumcision disrupts circulation: Circumcision interrupts the normal circulation of blood throughout the penile skin system and glans. The blood flowing into major penile arteries is obstructed by the line of scar tissue at the point of incision, creating backflow instead of feeding the branches and capillary networks beyond the scar. Deprived of blood, the meatus may contract and scarify, obstructing the flow of urine.35 This condition, known as meatal stenosis, often requires corrective surgery. Meatal stenosis is found almost exclusively among boys who have been circumcised.[...]Circumcision also severs the lymph vessels, interrupting the circulation of lymph and sometimes causing lymphedema, a painful, disfiguring condition in which the remaining skin of the penis swells with trapped lymph fluid."

Female preferences: Do females prefer circumcised penises?

Yes

Women prefer cleaner circumcised penis Many women prefer a circumcised penis. This is because they think of it as neater and cleaner. In addition, in so far as circumcision improves mens' stamina, it improves the sexual experience of women and their likelihood of orgasm.

Women prefer the appearance of a circumcised penis. A circumcised penis is neater. Instead of the foreskin covering the head of the penis in a crumpled form, the head of the penis is always exposed, which often arouses women.

Women are more likely to orgasm with circumcised men. During intercourse, the foreskin of the uncircumcised penis stays fixed against the side of the vagina, as the male thrusts in and out of his own foreskin. This feels good for the man, but provides far less stimulation for the woman. A circumcised penis does not offer this sliding action, so allows a women to enjoy the full friction of the penis entering and exiting her vagina. Women also enjoy the greater exposure and feel of the head of the penis.

Circumcision increases sexual stamina and satisfaction. A number of studies have found that circumcised males have greater stamina (or lower rates of premature ejaculation) than uncircumcised men. The longer a man can last, the more likely he is to cause a women to orgasm or orgasm multiple times.

A cultural preference for a circumcised penis is valid. Williamson et. al (1988). conclude: "Not least among the considerations is the worth of sexual preference for male circumcision within the American culture as a valid reason for continuing the practice."[3]

No

Attitudes should conform to the normal body, not visa versa. Some women prefer circumcised penises. Some prefer uncircumcised penises. There is not consensus. But, if views are supposed to conform in one direction or another, it is better that converge in the direction of the natural body, not visa versa.

Uncircumcised penis better stimulates a woman to orgasm."Circumcision Alters Sexual Function". National Organization of Circumcision Information. Opposing Views - "The movements and skin contact an intact man needs to reach orgasm are compatible with the movements and skin contact a woman needs to reach orgasm. The dryness, abrasion, and chafing complaints of some women, along with their inability to have an orgasm, are oftentimes complications of circumcision. A circumcised male has little lubrication of his own, and he removes much of a woman's vaginal lubrication with every outstroke. In addition, a circumcised male needs longer strokes to stimulate the small sensitive area (frenular remnant) on the underside of his penis to reach ejaculation. Each long outstroke distances him from the woman's clitoris, making it harder for her to ride the wave to orgasm."

Women preferring circumcised men suffer from cultural illsMary G. Ray. "The Sexual Preference for a Circumcised Penis and its Disadvantages". Mothers Against Circumcision. 31 Oct. 1999 - "There are American women who[...]insist that the natural male is unclean and unappealing. They say they prefer a circumcised male. These women are not unlike African men who demand that their wives be circumcised. This common bond between African men and American women demonstrates an ignorant intolerance for natural genitals. Both cultures are unmindful that circumcision hurts them as well. Cutting the genitals of either gender modifies the sexual experience of the person cut as well as their sexual partners. Meanwhile, in other cultures, Europe for example, where the circumcised penis is the exception, women say they prefer a natural penis. It is natural to assume the idea that we prefer what is familiar to us. 'in other cultures, Europe for example, where the circumcised penis is the exception, women say they prefer a natural penis.'"

Smegma: Is it a good or bad thing that circumcision eliminates smegma?

Yes

Smegma in uncircumcised penis produces unattractive smell/taste. Smegma is an excretion that gathers underneath the foreskin. It produces a foul oddor as well as taste, which can be exceedingly off-putting to women.

No

Mobile adult foreskin is very easy to clean. This question is pointless, because once the foreskin becomes fully mobile, washing under it is utterly trivial. To circumcise to prevent smegma would be like ripping out the nails to prevent dirt under the nails.

Smegma has an important natural, protective function.Paul M. Fleiss, MD. "The Case Against Circumcision". Mothering. Winter 1997 - "The white emollient under the child's foreskin is called smegma. Smegma is probably the most misunderstood, most unjustifiably maligned substance in nature. Smegma is clean, not dirty, and is beneficial and necessary. It moisturizes the glans and keeps it smooth, soft, and supple. Its antibacterial and antiviral properties keep the penis clean and healthy. All mammals produce smegma. Thomas J. Ritter, MD, underscored its importance when he commented, 'The animal kingdom would probably cease to exist without smegma.'"

Masturbation: How does circumcision relate to masturbation?

Yes

Circumcision discourages masturbation by making it less pleasurable Masturbation is considered in many cultures to be an undesirable practice. This relates to the fact that it is a form of self-gratification and because it distracts from the proper role of the male organ, which is sexual activity and procreation. Circumcision discourages masturbation because it makes it more difficult. This is because it makes it necessary to use lotion as lubrication, whereas the foreskin readily enables masturbation without lotion.

Social: Are there social reasons for or against circumcision?

Yes

Circumcision is a tradition worth preserving.Dr David Hawker. "The Benefits of Male Circumcision". CircInfo.com. March 2004 - "This is an operation as old as mankind, highlighted today by Jewish and Muslim tradition in which all males are usually circumcised as part of their faith. It is performed worldwide by many tribes and cultures as an initiation rite and, despite some aggressive opposition, it is routinely done at birth for the majority of boys in the USA as well as many in Australia, Canada, New Zealand, South Africa and much of the English speaking world - except, latterly, in the UK. Overall it is estimated that a quarter of the male population is circumcised - about 750 million males. They cannot all be wrong! Yet in Europe today there is widespread ignorance of its value."

No

Circumcision was used to reduce fertility of certain groups"Cutting the competition". The Economist. Jun 19th 2008 - "there are several ways it may affect fertility: most obviously, the lack of a foreskin could make insertion, ejaculation or both take longer. Perhaps long enough that an illicit quickie will not always reach fruition[...]Older men are in a position to form alliances with younger men—passing on knowledge, lending them political support and giving them access to weapons. By insisting that the young undergo genital mutilation of some form as a quid pro quo, an older married man can seek to ensure that even if he is cuckolded, he will still be the father of his wives’ children."

Dangerous cultural pressure exists surrounding circumcisionMary G. Ray. "Like Father, Like Son". 1997 - "I am very happy for my son that he is natural. Which is more important? Having a penis that looks like mine? Or enjoying the benefits a foreskin provides? [...] It doesn’t make sense that his foreskin should arbitrarily be cut off just because they did it back when I was born. Routine circumcision is a colossal mistake. The same mistake should not be done to him simply because it was unfortunately done to me. Two wrongs don’t make a right. It’s got to stop somewhere [...] All this concern about looking the same -- I think its rare for fathers, sons and brothers to pay much attention to each other’s penises. But if a difference is noticed, the absent foreskin can be so easily explained. They used to think removing the foreskin was necessary. Now they know, it’s not."

Religion: Do certain religions require circumcision?

Yes

Romans 4:9-12 supports the practice of circumcision. Romans 4:9-12: "Is this blessing then on the circumcised, or on the uncircumcised also? For we say, "FAITH WAS CREDITED TO ABRAHAM AS RIGHTEOUSNESS." 10 How then was it credited? While he was circumcised, or uncircumcised? Not while circumcised, but while uncircumcised; 11 and he received the sign of circumcision, a seal of the righteousness of the faith which he had while uncircumcised, so that he might be the father of all who believe without being circumcised, that righteousness might be credited to them, 12 and the father of circumcision to those who not only are of the circumcision, but who also follow in the steps of the faith of our father Abraham which he had while uncircumcised."[5]

No

Foreskin is a brilliant gift from nature and/or God. Foreskin has many important functions, and is a gift from natural evolution. God or nature intended for humans to have foreskin. Why would he alter these plans?

Circumcision is a product of strange historical mythologies. From the book, Babywatching by Desmond Morris - "It started as an ancient Egyptian custom and there are wall carvings to prove it. It seems to have its origin in snake worship. The Egyptians believed that when the snake shed its skin, and emerged shiny and new again, it was undergoing rebirth. They reasoned that if, by shedding skin, the snake could become apparently immortal, then humans should follow suit. They made the simple equation: snakeskin = foreskin, and the operation began. From there it spread to many Semetic peoples, both Arabs and Jews adopting it and converting it into an act of religious faith. As the centuries passed, it became popular in other regions of the world for moral, medical, or hygenic reasons."

Circumcision was used to reduce fertility of certain groups"Cutting the competition". The Economist. Jun 19th 2008 - "there are several ways it may affect fertility: most obviously, the lack of a foreskin could make insertion, ejaculation or both take longer. Perhaps long enough that an illicit quickie will not always reach fruition[...]Older men are in a position to form alliances with younger men—passing on knowledge, lending them political support and giving them access to weapons. By insisting that the young undergo genital mutilation of some form as a quid pro quo, an older married man can seek to ensure that even if he is cuckolded, he will still be the father of his wives’ children."